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Buccal Space

spatium buccale

The buccal space is the bilateral fat-filled space between the buccinator muscle medially and the skin and superficial fascia of the cheek laterally. It contains the buccal fat pad, the parotid duct, the facial artery and vein, and the buccal branches of the facial nerve. Superiorly it communicates with the infratemporal fossa; inferiorly with the submandibular space.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The buccal space is the primary route for odontogenic infection spread from upper premolar and molar teeth perforating the buccinator. It is also the space entered in buccal fat pad removal for facial contouring surgery (bichectomy). Buccal space abscess presents as cheek swelling lateral to the masseter, tender to palpation, without the trismus that characterises the masticator space. Drainage is through an intraoral horizontal incision posterior to the commissure in the buccal mucosa. The space is relevant in Stafne bone cavity (developmental salivary gland depression in the mandible) and in masseter muscle herniation.

Pathology

Common Injuries & Conditions

Buccal Space Abscess from Upper Molar Root Perforation

Upper molar periapical abscess perforating the buccal cortex enters the buccal space superficial to the buccinator, producing non-tender diffuse cheek swelling without trismus; intraoral drainage through an incision in the buccal vestibule at the tooth apex level decompresses the space and tooth extraction or root canal treatment addresses the primary source.